The nutrition supplement industry is a force to be reckoned with. There are billions of dollars spent each year on not only the research and development of new supplements, but the branding, marketing, and sales of those products. Most of the time though the marketing, branding, and sales part is even more important to these companies than the studies themselves. In order to sell a nutrition product you do not need to prove that it works, which makes it very easy to dupe unsuspecting consumers.
To be clear, I’m mostly talking about propietary blends, herbal stuff, weight loss or sport supplements that are more than just your single vitamin or mineral pill. Even those should only be taken after consultation with a nutrition professional, but we can talk about that another time!
The trouble is, most nutrition supplements do not live up to their claims (and can even be dangerous if taken incorrectly) but the majority of consumers haven’t taken courses on research methods or critical thinking to be able to read research papers and grade evidence. It’s easy to be awed by the impressive stuff the product labels say they can do when you aren’t a science expert, even more so when the people pushing the products claim to be. Walk down the aisle of a health food store (or open your social media and see the dozens of facebook posts by those annoying sales people), and you’ll see products available that claim to do it all. Lose weight, trim belly fat, grow muscles, improve heart health, better digestion, there’s a pill and potion for everything.
Ok, so how is it possible that a company can state their product is “clinically proven”, or that they have “hundreds of published studies” on their brand and yet they STILL don’t won’t do what they claim?
Crappy science, and extrapolation of evidence, that’s how.
I’ll give you an example.
A few years ago I was at a ‘conference’ (spoiler alert-it was really a sales pitch dressed up as a conference) for a popular brand of nutrition supplements available by direct sales, or network marketing, or whatever they like to call themselves these days. There was an education session about this company’s brand of calcium supplement. The study they were so proud of went something like this:
They recruited a few 13-year-old girls who had low calcium intake from food, and tested their bone mineral density. They gave these girls their brand of calcium supplement for a few months, and re-tested their bone mineral density. Voila, their bone mineral density improved, therefore their brand of calcium supplement is the best thing ever and we all should buy it.
Shut up and take my money, right?
Ok, let’s talk about why this is not impressive at all, and is actually fantastic example of really crappy science, designed to fool consumers and sell product.
First, and most importantly the study had no control group. A control group is a secondary group that should be included in EVERY study of this kind. The placebo group receives no treatment at all (or a placebo- a pretend treatment) to see how their results compare to the control group. The placebo effect is a REAL thing. There are actually scientists who dedicate their entire careers to studying this phenomenon, so it is important to always look for a control group in any study you read. In this particular case, it’s also important to note that we actually don’t reach peak bone mineral density until into our 20’s, so perhaps some of the improvement these girls experienced was actually due to the fact that they were older in the second test (again hence the need for that control group!) What this company also should have done is tested their brand of supplement against the same dose of a drug store brand (or hey, maybe ACTUAL FOOD), to see if their calcium was truly better than any other options out there. This is why these company reps don’t like Dietitians- we ask too many pesky questions!
Additionally, a larger sample size would be needed to really make this a worthwhile study. In order to claim that your product works for ‘everyone’, you need to actually test it on ‘everyone’. You need to include a wide range of people that represent the true population in your sample. For example different ages, sizes, ethnicities, dietary habits, physical activity, etc. Even factors like location (different sunlight exposure), other medications, or smoking might all have an effect on your outcome. These things need to be taken into consideration when designing your study and analyzing your data. To pick one certain population (in this example, 13 year old girls who are at risk of low bone mineral density presumably due to not getting enough calcium), your conclusion can only be used in THIS specific population. You can say “this brand of calcium supplement works to improve bone mineral density in 13-year-old girls who do not meet their calcium requirement from food”, NOT “Our calcium supplement is the only one that works and everyone else’s calcium is garbage, and there’s no way a good quality diet could match how great our supplement is”….Unfortunately that doesn’t quite have the same ring to it. But the fact is, when we start to assume that what works in one studied population is automatically going to work the same in every other population, we are extrapolating evidence, and that’s not cool.
Speaking of extrapolating, here’s another favourite example of mine. Different company this time, but same kind of nutrition junk for sale via network marketing. They have this AMAZING product that can cure basically EVERYTHING (as they always claim to do), and of course, it’s all based on science (insert eye roll). So I had a look at their website to read all these groundbreaking studies they kept bragging about. Guess what- not a single human trial in sight. That’s right- these supplements that they claim can cure cancer, skin disorders, diabetes, digestive woes, leaky gut, fatigue, etc, etc etc, have never even been TESTED in a human. Their big claim to fame? A test tube study. They put some ingredients from their nutrition supplement into a test tube that was set up to ‘mimic the environment of the stomach’ (which is impossible to do with any accuracy), and felt like that was good enough to start raking in cash. They claim their study design is better than using real people because it gets rid of other factors that could affect their outcome, but guess what? That’s not real life.
Test tube studies and research using animal models is NOT a good substitute for the human body. Just because something works in a test tube or in a mouse does not mean it will work the same way in a human
You see, human studies cost TIME and MONEY. You have to find and pay the participants, hire a larger team to run the study, pay the data analysis people and so on. You also have to pass ethical standards if you want your work to be published (that means no shady stuff like they used to get away with back in the day). “In Vitro” (test tube studies) on the other hand are much less expensive to complete, and the enzymes can’t sue you if something goes horribly wrong. Us humans are actually very complicated organisms and changing one thing (such as consuming an herbal supplement product) can have unintended dangerous consequences (like liver or kidney failure). Companies don’t want to take that risk. If you can still sell product with the bare minimum in research, why bother spending the money to properly back it up? Scary huh?
Another key thing to pay attention to when it comes to research is funding sources. Who paid for this study to be done? Often times the company who owns the product is also funding it’s research. This obviously leads to conflicts of interest. Why would a company publish study results that don’t support the use of their product? Studies are often set up in ways that are the most likely to show a benefit (like using In Vitro studies instead of human trials, or not using a control group in the calcium study)
We are complicated beings, and the things we ingest (food, supplements, medications, etc) have to pass a number of hurdles before they could potentially be used by our bodies. Our stomach acid alone is incredibly strong, ready to break down just about any protein that comes it’s way. Then we have a myriad of digestive enzymes produced by our stomach and GI tract which are tasked with turning when we ingest into it’s basic molecules. Is your supplement able to survive all of that? If we don’t produce the right enzyme to break down that substance, or lack the ability to transport it into the blood stream or our bodies’s cells, guess what? All that money is going right down the toilet. Literally
Dosing (how much of a supplement to take) is another important factor when discussing nutrition products. As I mentioned before, test tube and animal studies don’t give us great information about how things will work in a human body. What these studies also don’t tell us is how much of a supplement we should take to see any potential benefit. Obviously a mouse is much smaller than a human, and with a completely different set of body systems and genetics we have few metabolic similarities. It truly is a guessing game, and likely to be grossly overestimated to increase revenue for supplement companies (if you take 4 pills per day instead of two, you need to buy more twice as quickly- genius!). When we see no benefit of taking 4 pills, we might be tempted to increase that dose to 8 pills ’cause natural means safe right?
Unfortunately that could not be further from the truth. Natural products are equally as risky as taking any type of man-made supplement. Some of the most potent poisons in nature come from natural sources, so companies pretending that they can’t possibly do any harm because their products are all natural is downright wrong. The trouble is, because many of the people peddling these products are unlicensed “nutritionists” or just company reps, there is ZERO legal liability for them selling you dangerous stuff. If you get sick or your child gets sick from taking nutrition supplements at the advice of a non-regulated person, there is absolutely nothing you can do.
It is so important to see through the smoke and mirrors and ask questions about research methods when you are considering taking a nutrition supplement of any kind. The term ‘clinically proven‘ means nothing without context. Clinically proven in a test tube? Or in an actual human beings that come with the complication of genetics and lifestyle factors? The next time you’re subject to a sales pitch for the latest “amazing thing” ask for the proof, and when in doubt, always ask a Dietitian!
Have questions about supplements? Contact me!
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